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PLANREVI'EW CrH'EECK�1LIISTFOR <br /> (yNEW STRUCTURES / ADDITIONS <br /> Address: �� � U► 1 Permit No.: 2-o P 01 0�/' <br /> Description of work: r d I M Date Rec'd: ' 13 •G7 <br /> ,17 <br /> Septic review by: Date Approved: 1 <br /> Zoning review by: Date Approved: <br /> Building review by: 62 Date Approved: //z l <br /> Grading review by: Date Approved: <br /> Zoning District: Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution/ NA <br /> Zoning: Lot Area: SF/0 Width: Structural Coverage: SF % <br /> Survey Submitted: 0 Yes No Date of Survey: Revised date(?): <br /> Landscape plan submitted? 0 Yes Land per: 0 /None proposed <br /> Proposed Setbacks: {� <br /> Front(L e) Rear(Str t) 41k)S E W ) ( N S E W1 Other Buildings Wetland <br /> Side Side <br /> �--- 0Z HUI <br /> Buildina Hei ht Analysis: <br /> Distance Between First Floor and defined Top of Roof*(See"building height" (a) <br /> definition): <br /> First Floor Elevation from building plan (b) <br /> Highest Existing ground level (per surve 10' above lowest ground level, (c) <br /> whichever is lower: <br /> Difference between b and (c)*: (d) <br /> DEFINED HEIGHT <br /> If highest existing adjacent grade is above FFE-Height is(a)-(d): e) <br /> *If highest existing adjacent grade is below FFE-Height is a + d <br /> Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> Yes 0 No Permit Number: 0 Yes 0 No N/A 0 Yes No <br /> 0 N/A—see attached Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Required CUP Required <br /> circle one % ands % and s <br /> 0 Yes No 0 Yes No <br /> 1 2 � 4 5 Type(s): Type(s): <br /> Updated: June 2017 <br /> z:\forms\plan review checklist 06-2017.docx <br />